The REACH Project (Reaching for Excellence in Adolescent Care and Health) of the Adolescent Medicine HIV/AIDS Research Network is the only federally funded cohort study of HIV infection in adolescents infected through either sexual transmission or needle use. This is an observational cohort study looking at the manifestations of HIV infection in adolescents, studying both the biological impact as well as the mental impact of HIV infection in adolescents from 13 to 19 years of age. This study has succeeded in fully recruiting adolescents into the study and has a retention rate of 87.9%. There are 578 subjects enrolled into this study: 271 positive females, 164 negative females, 94 positive males, and 49 negative males. The Children's Hospital of Philadelphia ranked third in the national ranking of the 16 clinical sites for recruitment and retention. The base protocol of the study examined many aspects of HIV infection in adolescents: the immunologic response to infection; co-infection with other sexually transmitted diseases, such as HPV; the impact of infection on the mental health of the youth; and the longitudinal study of disease progression in adolescents, to name a few. In addition, there were a number of additions to the protocol, including a nutrition substudy , a retention study, an adherence program, and a social marketing campaign to promote HIV counseling and testing in youth. Through the impact of a comprehensive care team, the study has been quite successful in keeping youth engaged in care and in the study, as noted by the retention rate. During this last year of the study, recruitment into the study has stopped and youth already enrolled will continue to be studied until November 30, 2000. The study will end at this time and there will not be a continuation of this specific study.